The Influence of Stigma on the Course of Illness

Abstract

This chapter is about the impact of the stigma of mental illness on the illness course. Three different stages of the illness are examined: the time between illness onset and recognition, the first episode, and the long-term course. Generally, long-term panel studies are scarce. Best evidence is given for the long-term course of illness basing on several studies referring to Link’s modified labelling approach. These studies indicate that personal stigma (comprising perceived, experienced, and self stigma) is associated in the long run with impaired quality of life, decreased self esteem, and higher burden due to depression and further illness symptoms. Even though personal stigma is related to the illness course, it is not simply part of it, because the burden due to illness and symptoms usually improves over time while the burden due to stigma remains high.